Methods of manufacturing a medicated tampon assembly

ABSTRACT

A method is provided for manufacturing a medicated tampon assembly having a tampon body, the method including applying a formulation including a therapeutic agent to a substrate to produce a plurality of dosage forms; separating one of the dosage forms from the substrate; and coupling one of the dosage forms to the tampon body. A medicated tampon assembly is provided including a dosage form including a formulation including a therapeutic agent; a substrate portion separated from a substrate, wherein the substrate portion is coupled to the dosage form; and a tampon body having a distal end, wherein the substrate portion is coupled to the distal end of the tampon body.

This application claims priority as a continuation of application Ser.No. 11/090,554, filed on filed on Mar. 25, 2005 now U.S. Pat. No.7,993,667. The entirety of application Ser. No. 11/090,554 isincorporated herein by reference.

BACKGROUND

This invention pertains to methods of manufacturing medicated tamponassemblies used for the application of various therapeutic treatments orpreparations into the vaginal or other cavity.

Many disease states and physiological conditions may occur in a woman,including symptoms associated with premenstrual syndrome, menstruation,and menopause. These symptoms may include dysmenorrhea (menstrualcramping), irritability, water retention, moodiness, depression,anxiety, skin changes, headaches, breast tenderness, tension, weightgain, cravings, fatigue hot flashes, itching, and other associatedsensory maladies.

Many of these symptoms are due to changes in hormonal levels throughoutthe menstrual cycle. One example that affects a large number ofpost-pubescent women is dysmenorrhea, which is the occurrence of painfuluterine cramps during menstruation. Menstrual cramping is associatedwith increased levels of prostaglandin F2α, prostaglandin E2, and, insome cases, leukotrienes in the endometrium and menstrual fluid. Theseeicosinoids lead to restricted blood flow to the uterus and increaseduterine contractions, causing pain.

Various analgesics may be effective in limiting the pain fromdysmenorrhea; however some orally-delivered analgesics can cause nauseaand vomiting or other untoward side effects; therefore alternativeroutes of analgesic delivery are of interest.

Attempts have been made to deliver analgesics in the vicinity of thecervix and the vaginal mucosa using various vaginally-inserted devicesand methods. Because many of these symptoms typically occur inconjunction with menstruation, some have tried to combine an analgesicwith a tampon by coating the tampon, dipping the tampon, or by combiningthe analgesic with the tampon materials.

For example, in a method of preparation of such a product appropriatefor a laboratory setting, a formulation of a fatty compound excipientand an analgesic are heated to a liquid state. Constant mixing of theheated formulation is required to produce a homogeneous formulation. Theformulation is then poured onto the tip of a tampon held in a form tocontain the liquid. As the formulation cools, the ingredients solidifyinto a solid waxy substance that has adhered to the absorbent materialof the tampon and is thereby securely fastened to the tip of the tampon.

SUMMARY OF THE INVENTION

Several problems are inherent in a process that attempts to introduce aformulation including a therapeutic agent into or onto a tampon bycoating, dipping, solidifying, or the like. Processes such as these maywork in a laboratory setting but may not be feasible within an automatedtampon manufacturing process. Because of dosing requirements, theformulation including a therapeutic agent must be maintained in asolution that is both homogeneous and of the proper purity to ensureconsistent concentration of the therapeutic agent. These requirementsare difficult to accomplish during production operation of an automatedtampon manufacturing process, and are significantly more difficult tomaintain when the automated tampon manufacturing process stops. Inaddition, different styles and sizes of tampons may have differentdensities and will absorb an applied liquid formulation including atherapeutic agent differently, resulting in variability in therapeuticagent concentrations across such different tampons.

Specifically, the need to provide constant agitation or mixing of theformulation including a therapeutic agent poses challenges as to how tokeep a therapeutic agent homogeneously suspended in a solution when theautomated tampon manufacturing process stops. The use of inline mixersand recirculation of the heated liquid formulation during machine stopsmay provide a method to keep the formulation moving and mixed. However,because a machine could be stopped for several hours, the stability ofsome formulation mixtures may be compromised by long durations atelevated temperatures, or by mechanical shear forces due to thecontinuous pumping of the recirculating liquid.

The present invention solves these problems by coupling a dosage form toa tampon to form a medicated tampon assembly. The dosage form, whichincludes a therapeutic agent, is solid or semi-solid at roomtemperature, is sufficiently stable, and may be manufactured separatelyin a controlled facility, whereby dose is easily controlled throughcontrols on concentration and purity.

More specifically, the present invention relates to a method formanufacturing a medicated tampon assembly having a tampon body, themethod including applying a drug formulation including a therapeuticagent to a substrate to produce a plurality of dosage forms; separatingone of the dosage forms from the substrate; and coupling one of thedosage forms to the tampon body.

In another aspect, the present invention provides a medicated tamponassembly including a dosage form including a formulation including atherapeutic agent; a substrate portion separated from a substrate,wherein the substrate portion is coupled to the dosage form; and atampon body having a distal end, wherein the substrate portion iscoupled to the distal end of the tampon body.

The advantages of using a pre-manufactured dosage form over an in-lineprocess where the medicated ingredients are applied to the tamponcoincident with the tampon manufacturing process are numerous. Thedosage form would be desirably produced at a pharmaceutical manufacturerwhose manufacturing facility meets current regulatory and qualityrequirements for drugs and/or devices as appropriate. This could ensurethat a therapeutic agent with the correct dose and purity is dispersedwithin the dosage form. The use of separately-manufactured dosage formssimplifies the modifications to an existing tampon manufacturingprocess. The use of separately-manufactured dosage forms allows multipletypes of therapeutic agents to be applied to the tampon. The chemicaland physical stabilities of the dosage form are not compromised by theassembly process onto the tampon. The process is less dependent on thephysical characteristics of the absorbent structure of the tampon,because only a partial phase change of the dosage form may be requiredto bond with the tampon.

The present invention relates to a dosage form that is integral with orassociated with a feminine care product. The dosage form including thetherapeutic agent and excipients may include any therapeutic agent thatmay be absorbed into the body through the vaginal or other epithelium,or deposited topically on the vaginal or other epithelium, for thepurposes of treating a physiological disease, state, or condition.

Other objects and advantages of the present invention will become moreapparent to those skilled in the art in view of the followingdescription and the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a view of a two-piece tampon assembly to be used inconjunction with a medicated tampon assembly.

FIG. 2 is a cross-sectional view of the tampon assembly shown in FIG. 1.

FIG. 3 is a perspective view of a portion of a substrate carrying dosageforms to be used in conjunction with the medicated tampon assembly ofFIG. 2.

FIG. 4 is a simplified schematic view showing key features of themedicated tampon assembly of FIG. 2.

FIG. 5 is a schematic view illustrating the mechanism for die-cutting asubstrate carrying dosage forms.

FIG. 6 is a schematic cross-sectional view of one method ofmanufacturing the medicated tampon assembly of FIG. 2.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The invention as described herein will be described for exemplarypurposes using a tampon as an example of a feminine care product. Theinvention, however, applies equally to other forms of products,including tampon-like devices and vaginally-inserted devices, and shouldnot be limited to the example described herein. In addition, althoughthe example described includes a tampon with absorbent material, aproduct without absorbent material, such as a tampon applicator or othersimilar applicator, is also contemplated within the invention. Alsocontemplated is the use of the invention described herein in conjunctionwith non-catamenial feminine products such as incontinence products,including female incontinence inserts.

The term “surface” and its plural generally refer herein to the outer orthe topmost boundary of an object.

The term “dosage form” is used herein as a generic term for a unit formincluding a formulation that includes a therapeutic agent. The dosageform includes a discrete and consistent quantity of the therapeuticagent to allow for consistent dosing of one receiving the dosage form.The dosage form may be a suppository, a capsule, or any other suitableform. The dosage form may also be spherical, ovoid, domal, generallyflat, or any other suitable shape dictated by the needs of theapplication of the dosage form. The dosage form may have convex,concave, planar, arcuate, or any other suitable surfaces as dictated bythe needs of the application of the dosage form.

FIGS. 1-2 illustrate a delivery device in the form of a medicated tamponassembly 10, including a first member 14 and a second member 18, whichis designed to house a tampon 20 and provide a comfortable means ofinserting the tampon 20 into a woman's vagina.

The first member 14 of the medicated tampon assembly 10 may be in theform of a spirally wound, convolutely wound or longitudinally seamedhollow tube which is formed from paper, paperboard, cardboard, plastic,other suitable material, or a combination of such materials. Any plasticin the first member 14 is preferably polyethylene, but may bepolypropylene or other suitable plastic. The first member 14, alsocommonly referred to as an outer tube, may be of any suitable dimensionsnecessary to house a particular size of tampon 20. The first member 14has a wall 22 with an outside or exterior surface 24.

The first member 14 is sized and configured to house the tampon 20, andshould have a substantially smooth exterior surface 24 which willfacilitate insertion of the first member 14 into a woman's vagina. Whenthe exterior surface 24 is smooth and/or slippery, the first member 14will easily slide into a woman's vagina without subjecting the internaltissues of the vagina to abrasion. The first member 14 may be coated togive it a high slip characteristic. Wax, polyethylene, a combination ofwax and polyethylene, cellophane and clay are representative coatingsthat may be applied to the first member 14 to facilitate comfortableinsertion. The first member 14 itself may be formulated to give it ahigh slip characteristic, including the addition of additives to theresin from which the first member is made, or by an alteration inphysical structure of the exterior surface 24, such as adding pebblingor other bumps, to decrease the amount of surface area in contact withthe vaginal or other epithelium.

Referring to FIG. 1, an insertion tip 26 is shown having a pluralitypetals 27 that may radially open such that the insertion tip 26 has adiameter approximately equal to or greater than the diameter of thefirst member 14. The petals 27 may be either even or odd in number andmay be equally spaced apart or non-uniformly arranged. In anotheraspect, the insertion tip 26 may be provided without petals 27.

The first member 14 may have a fingergrip ring 28 located proximate thereceiving end 30. The fingergrip ring 28 provides an enlarged surfaceonto which one or more fingers of the user may rest.

As stated above, the medicated tampon assembly 10 includes a secondmember 18, also commonly referred to as an inner tube. The second member18, like the first member 14, may be a spirally wound, a convolutelywound or a longitudinally seamed hollow tube constructed from paper,paperboard, cardboard, plastic, other suitable material, or acombination thereof. The second member 18 may be constructed of the samematerial as the first member 14 or it may be made out of a differentmaterial. The second member 18 may also be a solid stick or use someother unique shape. It is also possible to form a finger flange 32 onthe free end 31 of the second member 18 to provide an enlarged surfaceonto which the user's forefinger may rest. The finger flange 32 therebyfunctions as a seat for the forefinger and facilitates movement of thesecond member 18 into the first member 14.

In an alternate aspect of the present invention (not shown), the firstmember 14 and second member 18 together may be replaced by a stickapplicator. The stick applicator is used to insert the tampon 20, afterwhich the stick applicator is withdrawn.

A tampon 20 may be an absorbent member primarily designed to be worn bya woman during her menstrual period to absorb menses and other bodyfluids. The tampon 20 includes a tampon body 34 and a withdrawal string36. The tampon body 34 is normally compressed into the form of acylinder and may have a blunt, rounded or shaped forward end. The tamponbody 34 has a forward or distal end 38 that is closer to the cervix whenthe tampon 20 is in use. The tampon body 34 also has a proximal end 39that is closer to the vaginal opening when the tampon 20 is in use. Thetampon 20 commonly has a withdrawal string 36 fastened to the tamponbody 34 and extending from the proximal end 39. The withdrawal string 36serves as a means for withdrawing the tampon 20 from the woman's vagina.Catamenial tampons suitable for use in the present invention include anyabsorbent material as is known in the art. The tampon body 34 may beformed into specific shapes such as various cup shapes to enhance thetherapeutic agent contact area with the cervix, posterior fornix,anterior fornix, lateral fornices, vaginal epithelium areas, orconformance to other anatomical areas within the vaginal or othercavity.

A medicated tampon assembly 10 includes the tampon 20 and also includesa therapeutic agent included in a dosage form 45. For the purposes ofthis invention, any therapeutic agent that will treat the vaginal orother cavity or will be absorbed into a user's body through the vaginalor other epithelium for the purposes of treating diseases or conditions,promoting the growth of normal vaginal flora, or promoting vaginalhealth may be used. Examples of therapeutic agents that may be usedinclude, but are not limited to, botanicals, vitamins, moisturizers,antifungal agents, antibacterial agents, pro-biotic agents, calcium,magnesium, hormones, analgesics, prostaglandin inhibitors, prostaglandinsynthetase inhibitors, leukotriene receptor antagonists, essential fattyacids, sterols, anti-inflammatory agents, vasodilators, chemotherapeuticagents, and agents to treat infertility.

Some therapeutic agents for use in this invention are absorbable throughthe vaginal epithelium and travel to the uterus by a unique portal ofveins and arteries that are known to exist between the vagina, thecervix, and the uterus. This anastomosis eliminates first-passmetabolism by the liver, effectively delivering higher concentrations ofthe therapeutic agent to the uterus than would otherwise be availablevia oral dosing. Those of skill in the art know the efficacy of varioustherapeutic agents when introduced at a particular anatomical location.For example, when the therapeutic agent is selected to treatdysmenorrhea, it preferably is selected from the following group:nonsteroidal anti-inflammatory drugs (NSAIDs), prostaglandin inhibitors,COX-2 inhibitors, local anesthetics, calcium channel blockers, potassiumchannel blockers, β-adrenergic agonists, leukotriene blocking agents,smooth muscle inhibitors, and drugs capable of inhibiting dyskineticmuscle contraction.

Alternatively, therapeutic agents modify the vaginal or otherenvironment to enhance the wellness of this anatomical region. Thebenefits may be rather basic, for example increasing comfort byproviding moisturization and/or lubricity. These benefits may also bemore complex, for example modulating epithelial cell function to addressvaginal atrophy. The beneficial therapeutic agents may reduce negativesensations such as stinging, burning, itching, etc, or introducepositive sensations to improve comfort.

In one aspect of the present invention, the dosage form 45 may beproduced in any suitable form including, but not limited to, tablets,capsules, suppositories, gels, disks, lozenges, films, coatings, andother forms. In an alternate aspect of the present invention, the dosageform 45 may be produced in an encapsulated form.

In another aspect of the present invention, the dosage form 45 may bedesigned to melt at approximately body temperature, or to dissolve orotherwise disperse in the presence of a sufficient aqueous or otherliquid trigger, or appropriate chemistry, such as a suitable pH. Thedosage form 45 may be in any suitable form including, but not limitedto, tablets, capsules, suppositories, disks, lozenges, films, coatings,and other forms.

Additionally, the dosage form 45 may be formed in any shape to promoteattachment to the distal end 38 of the tampon body 34 and/or to promotecontact with anatomical structures such as the vaginal epithelium, theposterior fornix, the anterior fornix, the lateral fornices, the cervix,or other structures.

The dosage form 45 may include any therapeutic agent, excipient,formulation, compound, or combination thereof that is desirable tointroduce into the vaginal or other cavity, including excipients topromote the functionality of the therapeutic agent. The excipients mayassist the release of the therapeutic agent, or assist in the absorbencyof the therapeutic agent into the vaginal or other epithelium. The useof excipients to facilitate the formulation, delivery, stability, andaesthetic properties of a therapeutic agent delivery system is wellknown to those familiar with the art.

Examples of materials that may accompany the therapeutic agent in thedosage form 45 include excipients, biologically-compatible adhesives,surfactants, and penetration enhancers. An example of a suitableexcipient is SUPPOCIRE suppository base, available from Gattefossé Corp.SUPPOCIRE suppository base is a semi-synthetic glyceride. An example ofa suitable biologically-compatible adhesive is hydroxypropylmethylcellulose (HPMC), available as METHOCEL*K15M from The Dow ChemicalCompany. An example of a suitable surfactant is polysorbate 80,available from Spectrum Chemical Manufacturing Corp. An example of asuitable penetration enhancer is LABRAFIL M 1944 C nonionic amphiphilicexcipient, available from Gattefossé Corp.

The dosage form 45 may be combined with any absorbent tampon design. Thedosage form 45 is preferably positioned at the distal end 38 of thetampon body 34. In alternate aspects of the present invention, thedosage form 45 may be positioned at the proximal or string end 39 of thetampon body 34, or any other suitable position between the distal andproximal ends 38, 39 of the tampon body 34. The dosage form 45 may bedesigned to partially or fully cover the distal end 38 of the tamponbody 34. The tampon body 34 may be formed into specific shapes such asvarious cup shapes to enhance the therapeutic agent contact area withthe cervix, posterior fornix, vaginal or other epithelium areas, orconformance to other anatomical areas within the vaginal or othercavity.

In other various aspects of the present invention, the tampon 20 mayinclude a recess, a dimple, a depression, a concavity, or a reservoir(generically a recess) 50 at the distal end 38 (see FIG. 2), at theproximal end 39, or at any point between the distal and proximal ends38, 39. The recess 50 is designed to accommodate the dosage form 45. Thedosage form 45 may be applied to the recess 50 by any method describedherein or by any other suitable method. In an alternate aspect of thepresent invention, the recess 50 may be formed as a simple dimple. Inother alternate aspects of the present invention, the distal end 38 ofthe tampon 20 may flat, convex, or of any other suitable shape orarrangement.

The dosage form 45 may be produced by the same manufacturer as themanufacturer of the tampon assembly 40. The dosage form 45 may also beproduced by a separate manufacturer and provided to the tamponmanufacturer in any suitable manner. As an example, a dosage formmanufacturer with a facility specifically designed for pharmaceuticalmanufacturing under cGMP, FDA, or other regulatory requirements mayproduce the dosage forms 45 under conditions such that homogeneity,concentration, and purity of the dosage form 45 are closely controlled,and such that production is in accordance with applicable regulations.The dosage form 45 may then be sealed and shipped to the manufacturer ofthe tampon assembly 40. In this manner, the dosage form 45 is producedby a manufacturer with appropriate experience, and the tamponmanufacturer may be relieved of establishing a pharmaceutical-productionfacility.

The dosage form 45 may be produced by applying the formulation includinga therapeutic agent to a substrate 60 (see FIG. 3). The substrate 60 maybe a film or any other generally planar material including paperproducts. The substrate 60 may be meltable, dissolvable, or chemicallyreactive. The material of the film may be similar or substantiallyidentical to the material of the dosage form 45, but may have propertiesdifferentiated from the material of the dosage form 45. Examples ofsuitable films include dissolvable films made from poly-vinyl alcohol,mixtures of pectin and poly-vinyl alcohol, gelatin, and HPMC. These andother suitable materials are described in U.S. Pat. No. 5,646,206 toCoffin et al. and entitled “Films Fabricated From Mixtures Of Pectin AndPoly(Vinyl Alcohol),” U.S. Pat. No. 5,529,782 to Staab and entitled“Dissolvable Device For Contraception Or Delivery Of Medication,” USPatent Application No. 2004/0224008 A1 entitled “Dissolvable BackingLayer For Use With A Transmucosal Delivery Device,” US PatentApplication No. 2004/0043061 A1 to Leon et al. and entitled “DissolvableFilms Comprising Suspended Non-Soluble Pharmaceutically ActiveIngredients, Apparatus And Methods For Their Manufacture And Use,” USPatent Application No. 2002/0161088 A1 to Cochvar et al. and entitled“Rapidly Dissolvable Polymer Films And Articles Made Therefrom,” andNagata, Shunji, “Advantages to HPMC Capsules: A New Generation's HardCapsule,” Drug Delivery Technology, March/April 2002, Vol. 2, No. 2,available at Internet site www.drugdeliverytech.com.

Many suitable materials, including an excipient, may be used to form thesubstrate 60. As an example of an excipient material with desiredproperties, SUPPOCIRE suppository base or other semi-synthetic glycerideis available in different compounds having different melt properties.SUPPOCIRE suppository base or other semi-synthetic glyceride may be usedas a significant excipient component of the dosage form, as well as theprimary component of the substrate 60.

In various aspects of the present invention, the substrate 60 may bedurable or semi-durable, and materials in the substrate 60 may includeplastics, cellulose, metals such as aluminum, thermo-formed films, MYLARfilm or MYLAR film composites, or other suitable or pharmaceutical-gradematerials.

In a different aspect of the present invention, the substrate 60 may beformed with dimples, pockets, or other suitable recesses. Theformulation including a therapeutic agent, when applied to the substrate60, will fill the recess and take on the shape of the recess. The recessis thus shaped to create the desired shape of the dosage form. Thesubstrate 60 may be in the form of a sheet, a strip, or any suitableform. Once the recesses of the substrate 60 are filled with theformulation including a therapeutic agent, the substrate 60 may berolled, stacked, or otherwise packaged as appropriate and shipped and/orfurther processed. The substrate 60 may be fed into a machine processwhere the dosage forms may be removed from the substrate 60 by cutting,dumping, a pick and place mechanism, or any other suitable method.

The dosage form 45 may be produced by applying a metered amount of theformulation including a therapeutic agent to the substrate. Theformulation including a therapeutic agent may be applied to thesubstrate 60 by inkjet printing or by any other suitable printingmethod. The formulation including a therapeutic agent may also beapplied to the substrate 60 by depositing a metered amount of theformulation including a therapeutic agent onto the substrate 60 usingany suitable equipment, including a positive-displacement pump. Anyother suitable method of applying the formulation including atherapeutic agent to the substrate 60 may be used. In addition, morethan one layer of therapeutic agent or other material may be applied tothe substrate 60 by any of these methods. Any number of applications maybe made to the same substrate 60. If the substrate 60 is a strip, theformulation including a therapeutic agent may be applied sequentially tocreate a series of dosage forms 45 on the substrate 60. Such series ofdosage forms 45 may be arrayed on the substrate 60 in either a one- ortwo-dimensional array. The substrate 60 may then be fed into a machineprocess to be automatically merged with a series of tampon bodies 34, asdescribed below.

Once the formulation including a therapeutic agent is applied to thesubstrate 60 to create a plurality of dosage forms 45, the substrate 60may be cut to create individual dosage forms 45. This cutting may beperformed by die-cutting or any other suitable method. The dosage forms45 may also be removed from the substrate 60, leaving the substrate 60intact.

Referring to FIG. 5, in one aspect of the present invention, thesubstrate 60 carrying the dosage forms 45 may be fed into a machineprocess. For example, a substrate 60 in the form of a strip carrying aplurality of dosage forms 45 may be passed along a die 70 including atleast one plate 75 containing an aperture 80, where the plate 75 andaperture 80 define a plane. The plate 75 may be oriented vertically,horizontally, or in any other suitable orientation. If the substrate 60in the form of a strip carrying a plurality of dosage forms 45 is passedalong a die 70 including at least two plates 75 each containing anaperture 80, such apertures 80 are axially aligned. The aperture(s) 80is/are sized to permit a dosage form 45 to pass therethrough.

As the dosage form 45 on the substrate 60 strip moving past theaperture(s) 80 becomes axially-aligned with the aperture(s) 80, a pusher85 is moved toward the aperture(s) 80 in a direction generallyperpendicular to the plane of the plate 75 such that the pusher 85contacts the substrate 60, forcing the substrate 60 against the die 70to cut the substrate 60. In this method, the substrate 60 is cut to thesize of the aperture 80, which is sized to accommodate the dosage form45, leaving a substrate portion 90 attached to the dosage form 45. Inthis method, the pusher 85 may be moved to, through, or partiallythrough the aperture(s) 80, forcing the strip to be cut by theaperture(s) 80, thus leaving an individual dosage form 45 and itsattached substrate portion 90.

In a different aspect of the present invention, the pusher 85 may bereplaced with a tampon body 34, thus causing the substrate 60 includingthe individual dosage form 45 to be cut by the aperture(s) 80 as thetampon body 34 is advanced. By employing appropriate means describedbelow, the act of moving the tampon body 34 against the substrate 60 andtoward the aperture(s) 80 can, in addition to cutting the substrate 60,result in the dosage form 45 and its associated substrate portion 90becoming coupled to the tampon body 34. The tampon body 34 may be movedthrough or at least partially through the aperture(s) 80 by any suitableforce, including air pressure.

In addition, the tampon body 34 may be moved through the aperture(s) 80at least partially into a first member 14. In doing so, the cut dosageform 45 may be captured within the first member 14 adjacent the tamponbody 34. In any of these cases, the process of feeding a strip ofsubstrate 60 carrying dosage forms 45 may be a part of a larger processof manufacturing a tampon, or may be done on a separate line.

In a different aspect of the present invention, the substrate 60 may becut so as to leave a substrate portion 90 larger than the dosage form45. The substrate portion 90 left in this method may be circular,strip-shaped, or any other suitable arrangement or size. In this method,the substrate portion 90 will cover more of the tampon body 34 as shownin FIG. 4 when the dosage form 45 and substrate portion 90 are coupledto the tampon body 34. In a different aspect of the present invention,any suitable method of removing the dosage form 45 and a substrateportion 90 from the strip of substrate 60 may be employed. In adifferent aspect of the present invention, the substrate 60 may bemanufactured from a material suitable for sealing a dosage form 45 in afirst member 14 or other device. In various aspects of the presentinvention, the substrate portion 90 may remain with the dosage form 45,or the substrate portion 90 may be separated from the dosage form 45 anddiscarded

In a different aspect of the present invention, the tampon body 34 orthe pusher 85 may be advanced against a side of the substrate 60opposite the side on which the dosage form 45 is resident with enoughforced to break through the substrate 60 to push the dosage form 45 awayfrom the substrate 60. In another aspect of the present invention, thepusher 85 may be advanced against a side of the substrate 60 oppositethe side on which the dosage form 45 is positioned such that the dosageform 45 contacts and engages with a tampon body 34. In this aspect ofthe present invention, because the dosage form will exhibit a higheraffinity for engaging the tampon body 34 than the substrate 60, thedosage form 45 will remain with the tampon body 34 once pressure fromthe pusher 85 is released.

Once the individual dosage forms 45 are separated from the substrate 60,a dosage form 45 may then be coupled to a tampon body 34 by any methoddescribed herein. In a first case, the dosage form 45 may be coupled tothe tampon body without the substrate portion 90. In a second case, thesubstrate portion 90 may remain with the dosage form 45.

For the first case, in one method of coupling the dosage form 45 to thetampon body 34, a portion of the dosage form 45 is heated to melt all orsome of that portion of the dosage form 45. Such heating may beaccomplished using heated air, heated liquid, infrared, or any othersuitable heating means. The dosage form 45 is then abutted with thetampon body 34 such that the melted region of the portion is appliedwith appropriate pressure to engage the tampon body 34. The meltedregion of the portion then re-solidifies, becoming attached to thetampon body 34. In one aspect of the present invention, the dosage form45 is thereby mechanically engaged with the fibers of the tampon body34. In a different aspect of the present invention, the tampon body 34may be heated and then put in contact with the dosage form 45, thususing the heat from the tampon body 34 to heat and melt at least part ofthe dosage form 45.

In a different aspect of assembly for the first case, the dosage form 45is at least partially coated with a suitable biologically-compatibleadhesive such as HPMC or other suitable adhesive and then abutted withthe tampon body 34 such that the dosage form 45 is affixed to the tamponbody 34. The HPMC may be applied alternatively or additionally to one ofthe tampon body 34 or the dosage form 45.

In a different aspect of the present invention, usable in either case,the attachment may be accomplished in a manufacturing environment byintroducing a small amount of heated, melted excipient such as SUPPOCIREsuppository base or other semi-synthetic glyceride onto the tampon body34 just prior to introducing the dosage form 45 onto the tampon body 34.The heat contained in the melted excipient partially melts the dosageform 45 and creates a secure bond when both the dosage form 45 and theintroduced excipient cool and harden. The heated excipient may beapplied alternatively or additionally to one of the substrate portion 90or the dosage form 45.

A tampon body 34 with a fiber structure that is less dense could absorbsome or all of heated liquid excipient applied or produced in theprocess of coupling the dosage form 45 to the tampon body 34. In use atbody temperature, the excipient may also melt and might tend to absorbfurther into the tampon body 34 instead of desirably migrating to thevaginal or other epithelium. For such tampons and for the second case,the substrate portion 90 may be used between the dosage form 45 and thetampon body 34. One of the primary purposes of the substrate portion 90once it is being added to the medicated tampon assembly 10 is to inhibitany of the dosage form 45 from absorbing into the tampon body 34 duringmanufacture. A second primary purpose of the substrate portion 90 is toremain at least partially intact longer than the dosage form 45 when inuse, thus significantly inhibiting the dosage form 45 from absorbinginto the tampon body 34 during use.

Both purposes are accomplished by providing a substrate 60 withproperties differentiated from the properties of the dosage form 45. Forexample, the substrate 60 and the dosage form 45 may be formed fromsimilar or dissimilar materials as long as the substrate 60 has a highermelting point than the dosage form 45. In another example, the substrate60 and the dosage form 45 may be formed from similar or dissimilarmaterials as long as the substrate 60 has a lower solubility than thedosage form 45. In another example, the substrate 60 and the dosage form45 may be formed from similar or dissimilar materials as long as thesubstrate 60 has a lower chemical reactivity than the dosage form 45.The properties may also be mixed; a dosage form 45 that undergoes aprimary structural change through melting may be combined with asubstrate 60 that undergoes a primary structural change throughdissolution, as long as the substrate 60 generally lasts longer in usethan the dosage form 45.

In a specific example, the dosage form 45 is produced primarily fromexcipient that melts at human body temperature (about 37° C.±). Thesubstrate 60 is produced primarily from excipient that melts at a highertemperature (e.g., 42-45° C.). Such a structure would inhibit migrationof the therapeutic agent into the tampon body 22 during use because theexcipient in the dosage form 45 carrying the therapeutic agent meltsmore quickly than the excipient in the substrate portion 90, which ispositioned between the dosage form 45 and the tampon body 34. In otherwords, the excipients are selected such that the substrate 60 has a heatof fusion greater than the heat of fusion of the dosage form 45. Thesame effect is found when using a dosage form 45 and a substrate 60 ofdifferentiated properties, such as different rates of solubility orchemical reactivity.

In a different aspect of assembly for the second case, the substrateportion 90 is at least partially coated with a suitablebiologically-compatible adhesive such as HPMC or other suitable adhesiveand then abutted with the tampon body 34 such that the dosage form 45 isaffixed to the tampon body 34. The HPMC may be applied alternatively oradditionally to one of the tampon body 34 or the substrate portion 90.

In a different aspect of assembly shown in FIG. 6, an applicator firstmember 14 is positioned in a mold or holder 95. A dosage form 45 with asubstrate portion 90, preferably one in which the substrate portion 90is larger than the dosage form 45, is positioned at the receiving end 30of the first member 14, with the dosage form 45 positioned toward thefirst member 14 (see FIG. 6 a). A tampon body 34 and optionally a secondmember 18 are aligned with the first member 14 and are moved into thefirst member 14, thus pushing the dosage form 45 with substrate portion90 into the first member 14 (see FIG. 6 b) at the distal end 38 of thetampon body 34 (see FIG. 6 c). Alternatively, the mold 95 may be heatedsuch that the dosage form 45 at least partially melts and conforms tothe insertion tip 26 of the first member 14 (see FIG. 6 d).

In a different aspect of the present invention, if the substrate 60 is apaper product or other durable and semi-durable material, then thesubstrate portion 90 will need to be removed from the dosage form 45prior to coupling the dosage form 45 to the tampon body 34. In suchcase, the dosage form 45 may be coupled to the tampon body 34 by any ofthe methods described herein.

In use, and referring to FIG. 2, the medicated tampon assembly 10functions because the second member 18 is telescopically movablerelative to the first member 14. The user may position one or morefingers on the fingergrip ring 28 and one or more fingers on the fingerflange 32. The user then squeezes the fingergrip ring 28 and pushes thefinger flange 32 toward the fingergrip ring 28 to force the secondmember 18 further into the first member 14 until the dosage form 45 isexpelled from the first member 14. More specifically, as the secondmember 18 is pushed into the first member 14, the tampon 20 is forcedforward against the petals 27. The contact by the tampon 20 causes thepetals 27 to radially open to a diameter that is sufficient to allow thetampon 20 to be expelled from the first member 14. With the tampon 20properly positioned in the vaginal or other cavity, the medicated tamponassembly 10 is withdrawn and properly discarded.

Once the tampon 20 is properly positioned in the vaginal or othercavity, the tampon body 34 absorbs menses and other bodily fluids, andthe dosage form 45 delivers the therapeutic agent to the vaginal orother epithelium for local or topical therapeutic action or from there,the therapeutic agent may be transferred to the uterus by normal bodilyfunctions to relieve the condition to be treated.

The invention has been described with reference to various specific andillustrative aspects and techniques. However, it should be understoodthat many variations and modifications may be made while remainingwithin the spirit and scope of the invention.

Accordingly, this invention is intended to embrace all suchalternatives, modifications and variations that fall within the spiritand scope of the appended claims.

1. A medicated tampon comprising: a tampon body; an at least partiallydissolvable or meltable planar substrate including a dosage formcomprising a probiotic agent and an antifungal agent; wherein the dosageform is combined with the tampon body.
 2. The medicated tampon of claim1 wherein the dosage form further comprises a botanical agent.
 3. Themedicated tampon of claim 1 wherein the dosage form is attached to asubstrate comprising a film identical to the material of the dosageform.
 4. The medicated tampon of claim 1 wherein the dosage form isattached to a substrate comprising a dissolvable film comprisingpoly-vinyl alcohol, pectin, gelatin, HPMC or combinations thereof. 5.The medicated tampon of claim 1 wherein the dosage form comprises a gel.6. The medicated tampon of claim 1 wherein the dosage form comprises acoating.
 7. The medicated tampon of claim 1 wherein the dosage formcomprises a film.
 8. The medicated tampon of claim 1 wherein the tamponhas a distal end and a proximal end, and the dosage form is positionedtherebetween.
 9. A method of manufacturing a medicated tamponcomprising: manufacturing a tampon body; forming an at least partiallydissolvable or meltable planar substrate separate from the tampon body,the substrate including a therapeutic agent; and combining the substratewith the tampon body, wherein the therapeutic agent comprises aprobiotic agent, an antifungal agent or a combination thereof.
 10. Themethod of claim 9 wherein a dosage form including the therapeutic agentis applied to the substrate.
 11. The method of claim 9 wherein thesubstrate comprises a chemically reactive planar material.
 12. Themethod of claim 10 wherein the substrate comprises a film comprising amaterial that is identical to the material dosage form, yet hasproperties that are differentiated from the properties of the dosageform.
 13. The method of claim 10 wherein the substrate is formed withdimples, pockets or recesses to which the dosage form is applied. 14.The method of claim 13 wherein the substrate is rolled.
 15. The methodof claim 13 wherein a plurality of substrates are stacked.
 16. Themethod of claim 10 wherein the dosage form is applied to the substrateby printing.
 17. The method of claim 9 wherein the tampon body comprisesan absorbent material formed from fibers that are assembled into aribbon.
 18. The method of claim 9 wherein the tampon body comprises anabsorbent material formed from fibers that are assembled into a sheet.19. The method of claim 10 wherein the dosage form comprises anexcipient that melts at human body temperature.
 20. The method of claim19 wherein the dosage form is in the form of a film.